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Late appearance and exacerbation of primary Raynaud’s phenomenon attacks can predict future development of connective tissue disease: a retrospective chart review of 3,035 patients

Rheumatology International volume 33, pages 921–926 (2013)Cite this article

Abstract

To assess the prognostic value of the age at onset of Raynaud’s (RP) and of a history of exacerbation of RP attacks for the development of connective tissue disease (CTD) in patients initially found to have primary Raynaud’s. 3,035 patients with primary RP (2,702 women and 333 men) were followed for an average of 4.8 years (range from 1 to 10 years). At baseline and every 6 months, they were screened for signs and symptoms of CTD. At 4.8 years of follow-up, 54.7 % patients remained as primary RP, 8.1 % had developed suspected secondary RP, and 37.2 % had developed a definite CTD. Primary RP patients had an earlier onset of RP (mean age of 32.2 years) than those with suspected (mean age 36.5 years, P = .007) or definite secondary RP associated with CTD (mean age of 39.8 years, P = .004). RP beginning before the age of forty was not significantly associated with the development of CTD. Conversely, the appearance of RP after the age of 40 was significantly associated with the development of CTD (P = .00001). Worsening of RP attacks predicted the development of CTD, especially systemic sclerosis (relative risk [RR] of 1.42), scleroderma overlap syndrome (RR of 1.18), and mixed CTD (RR of 1.18). Patients whose onset of RP occurred past 40 years of age and those with worsening RP attacks were at risk for the future development of CTD.

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Acknowledgments

We are indebted to Ministry of science of Republic of Serbia. This work was supported by research grant number 175041 for 2011–2014, issued by the Ministry of science of Republic of Serbia.

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Authors and Affiliations

  1. Institute of Rheumatology, Belgrade, Serbia

    Slavica Pavlov-Dolijanovic

  2. University of Belgrade, Faculty of Medicine, Institute of Rheumatology, Belgrade, Serbia

    Nemanja S. Damjanov, Nada Z. Vujasinovic Stupar, Goran L. Radunovic & Roksanda M. Stojanovic

  3. University of Belgrade, Faculty of Medicine, Institute of Medical Statistics and Informatics, Belgrade, Serbia

    Dragan Babic

Authors
  1. Slavica Pavlov-Dolijanovic
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  2. Nemanja S. Damjanov
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  3. Nada Z. Vujasinovic Stupar
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  4. Goran L. Radunovic
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  5. Roksanda M. Stojanovic
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  6. Dragan Babic
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Correspondence to Slavica Pavlov-Dolijanovic.

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Pavlov-Dolijanovic, S., Damjanov, N.S., Vujasinovic Stupar, N.Z. et al. Late appearance and exacerbation of primary Raynaud’s phenomenon attacks can predict future development of connective tissue disease: a retrospective chart review of 3,035 patients. Rheumatol Int 33, 921–926 (2013). https://doi.org/10.1007/s00296-012-2484-3

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  • DOI: https://doi.org/10.1007/s00296-012-2484-3

Keywords

  • Raynaud’s phenomenon
  • Connective tissue disease
  • Systemic sclerosis
  • Outcome